This course offers a core clerkship experience that exposes the student to the varied types of clinical practice in OB/GYN. One week is spent in the ambulatory setting, 2 weeks in labor and delivery, and three weeks in the gynecologic operating room. This allows for a breadth of experience in both types of patients encountered and faculty specialists. The ambulatory experience is based upon a preceptor model in which each student is paired with a general OB/GYN faculty preceptor who directs his or her outpatient experience. This outpatient experience is longitudinal throughout the clerkship - the student has an ambulatory session once a week with their core preceptor. This maintains continuity in both patient care and the student's own learning under the preceptor's guidance. In addition, students have a week-long outpatient experience that includes sessions with a reproductive endocrinologist, a maternal fetal medicine specialist, a gynecologic oncologist, a urogynecologist, a colposcopy and laser specialist, and a general gynecologist.
The labor and delivery experience includes participation in normal deliveries, cesarean sections, high risk obstetrics, and postpartum care. The gynecologic experience includes participation in general gynecology, gynecologic oncology, minimally invasive gynecologic surgery, and urogynecologic surgery.
Approximately 3-4 formal teaching presentations per week are given by faculty, which complement the clinical experience so that full curriculum objectives are met. Weekly formal student case presentations with the chief resident are done in order to practice oral presenting and to review relevant issues in patient care. A mid-clerkship afternoon lunch with the clerkship directors allows for informal career counseling and educational reflection during each clerkship.
Students are supplied with recommended textbooks from the OB/GYN department library. Meals on-call are supplied by a voucher system in the hospital cafeteria. Students take call until 10 pm. Evaluation is based upon clinical performance, oral exam performance, and the NMBE OB/GYN subject examination.
- Obtain an accurate, efficient, appropriate, and thorough history.
Specifically: chief complaint, present illness, menstrual history, obstetric history, gynecologic history, contraceptive history, sexual history, family history, social history.
- Perform and and interpret findings of a complete and organ-specific exam.
Specifically: perform a painless ob/gyn examination as part of a general medical examination including: breast exam; abdominal exam; pelvic exam; recto-vaginal exam.
- Perform routine technical procedures.
Specifically: collect a cervical cytological (pap) smear, obtain specimens to detect sexually transmitted diseases, bladder catheterization.
- Articulate a cogent, prioritized differential diagnosis based on initial history and exam.
Specifically: normal obstetrics, abnormal obstetrics, control of reproduction, gynecologic disorders, gynecologic endocrine and infertility issues, gynecology oncology.
- Design a diagnostic strategy to narrow an initial differential diagnosis demonstrating knowledge of pathophysiology and evidence from literature.
Interpret data from laboratories and radiology demonstrating knowledge of pathophysiology and evidence from literature.
- Design a management strategy for life-threatening, acute, and chronic conditions demonstrating knowledge of pathophysiology and evidence from literature.
Specifically: obstetrical hemorrhage, shoulder dystocia, menorrhagia, pelvic pain, ectopic pregnancy.
Practice-Based Learning and Improvement
- Plan a strategy for reducing incidence, prevalence, and impact of disease demonstrating knowledge of pathophysiology, clinical epidemiology, and evidence from the literature.
Specifically: preconception planning, contraception, nutritional counseling in pregnancy, premature delivery.
- Achieve the basic knowledge, skills and attitudes, which all physicians practicing in the 21st century should acquire to provide health care for all women.
Interpersonal and Communication Skills
- Present patient information and orders concisely, accurately, and in timely fashion to members of a health care team in a variety of settings and formats including verbally and in writing.
- Keep patient and family involved and informed - clearly, accurately, and sensitively.
- Be selfless, reliable, honest, and respectful of patients, colleagues and staff.
- Take initiative and responsibility for learning, achieving personal growth and improvement, and supporting the learning objectives of others.
- Demonstrate knowledge and affirmation of ethical standards.
- To learn to utilize cultural understanding of socioeconomic, gender, and age-related issues in patient interactions and decision making.
- Learn how your interests, strengths and weaknesses are suited to different fields.
- Understand the health and well being of populations.
Specifically: the social and health policy aspects of women's health (Example: ethical issues surrounding sterilization and abortion, domestic violence, adolescent pregnancy and racial and ethnic health disparities).
|Obstetrics & Gynecology Medical Student Clerkship
Beth Israel Deaconess Medical Center
Boston, MA 02215